- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $8,511.38 / $14,454.40
| Facility | | $1,778.28 | $8,511.38 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $12,022.64 / $24,547.09
| Facility | | $9,549.93 | $12,022.64 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,905.46 / $9,772.37
| Facility | | $831.76 | $1,905.46 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,995.26 / $2,041.74 / $2,818.38
| Professional | | $1,995.26 | $2,041.74 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $7,413.10 / $9,120.11
| Facility | | $6,309.57 | $7,413.10 | $9,120.11 |